Medicine & USMLE

Lamotrigine

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Antiseizure Drugs
  1. Ethosuximide
  2. Gabapentinoids
  3. Levetiracetam
  4. Lamotrigine
  5. Valproic Acid
  6. Phenytoin
  7. Carbamazepine
  8. Oxcarbazepine
  9. Topiramate
  10. Lamotrigine
  11. Levetiracetam (Old)

Summary

Lamotrigine is a drug that works by blocking sodium channels.

Clinically, it is used as a broad spectrum antiepileptic drug, meaning it can treat both generalized and focal seizures. In addition to seizures, lamotrigine is also used as a mood stabilizer to treat bipolar disorder.

Lamotrigine can cause several side effects, including sedation, headache, dizziness, and diplopia. Skin-related reactions, such as rash, Stevens-Johnson Syndrome, and DRESS syndrome, are also possible. Many patients may also experience nausea and vomiting. Lastly, lamotrigine may cause an increased risk of suicidal thoughts and behaviors.

Key Points

  • Lamotrigine
    • Mechanism
      • Blocks Na+ channels
        • Because Na+ channels are used for most neural action potentials, this can suppress neuronal activations, leading to broad-spectrum antiepileptic effects
    • Clinical Use
      • Treats seizures (antiepileptic)
        • Broad-spectrum
          • Treats partial (focal) seizures
          • Treats generalized (tonic-clonic) seizures
      • Treats bipolar disorder
        • Mood stabilizer
        • Particularly useful for treating depressed phase
    • Side Effects
      • Sedation
      • Dizziness
      • Rash
      • Headache
      • Nausea/vomiting
      • Diplopia
      • DRESS
      • Steven Johnson Syndrome (SJS)
        • Drug-induced skin and mucosal reaction that may lead to necrosis and peeling
        • Dose-limiting and relatively common; dose must be titrated slowly
      • May increase suicide risk